Form cover
Page 1 of 2

Take Off in Zero-G Application

Application Form

What is your full name?

Email

What is your phone number?

Select your nationality

Where are you currently located?

Are you available Aug 25-28th?

Are you available Aug 25-28th?

Link to video submission answering the following Questions:

1. Why do you want to become a space communicator? 2. What unique perspective do you bring to space communication? 3. Why does space storytelling matter in your region?

I acknowledge that I have read and agree to the Program terms and conditions (LINK)

I acknowledge that I have read and agree to the Program terms and conditions (LINK)
* By providing your email, you will be automatically subscribed to the Space for Humanity newsletter, where you can stay updated on the winners of this giveaway. You may unsubscribe at any time.